Pancreatitis
Pancreatitis is acute or chronic inflammation of the pancreas. It may be caused by infection, or irritation from the pancreas' own production of digestive enzymes. Pancreatitis, whether chronic or acute, usually requires a lowering of dietary fat levels, which can be tricky to combine with the low-carb diet required by diabetics. This condition plus diabetes usually requires a custom-designed medium-carb diet. There is evidence to suggest that chronic, subclinical (unable to be ascertained through present testing methods) pancreatitis is common in canines with diabetes Dr. Rand, et. al.-Chronic Subclinical Pancreatitis is Common in Diabetic Dogs-University of Queensland 2004. A study conducted by Drs. Fleeman and Rand puts the estimate of canine diabetics with pancreatitis--either acuteImage Illustrating Acute Pancreatitis or chronic Image Illustrating Chronic Pancreatitis--at about 40%Veterinary Clinics of North America-Small Animal Practice-2001-Management of Canine Diabetes-Drs. Fleeman & Rand. Chronic pancreatitis can lead to maldigestion syndrome in which the pancreas fails to produce enough digestive enzymesPurina ONE Health Library-Diabetes Mellitus. A severe attack is capable of damaging the exocrine pancreas, which produces the digestive enzymes and the endocrine pancreas, which produces insulin. Having a severe attack also puts one at risk for developing chronic pancreatitisCNN.com Health Library-Pancreatitis Overview. While both dogs and cats can suffer from chronic pancreatitis, the species differ when it comes to signs of it. Dogs tend to have repeated acute episodes while cats appear to have gradual inflammation with difficult to pinpoint signs of illness. Some research indicates that male cats are more prone to be sufferers of chronic pancreatitis than femalesHills Pet Products-Owner's Guide to Pet Care-Pancreatitis. This 2000 lecture given at the District of Columbia Academy of Veterinary Medicine regarding managing acute pancreatitis in dogs and cats refers to an (uncited) study suggesting that cats with pancreatitis are quite sensitive to insulin Pettalk.com-Feline Diabetes. A 1989 study of persons with pancreatitis-caused diabetes also seems to point to the same effect in humansPubMed-Diabetes Care 1989-Pancreatic Diabetes Mellitus, noting that those in the study had low glucagon levels which did not respond normally. The lack of normal glucagon action, which raises blood glucose levels, appears to indicate problems with the way the body responds to hypoglycemia. It goes on to mention that their epinephrine responses to insulin-related hypoglycemia is also abnormal. With epinephrine aka adrenalin acting counter to insulin by raising blood glucose levels, this would seem to further signal problems with the way the body is able to respond to hypoglycemia for those with pancreatitis and diabetes. Another human-based studyJournal of Clinical Pathology 1984-Exocrine Pancreatic Function in Diabetes Mellitus suggests that there is a correlation between the endocrine pancreas associated with diabetes and the function of the exocrine pancreas associated with pancreatitis. Insulin-dependent diabetics were rated as having the most severe exocrine pancreas deficit. Those who were able to control their diabetes with oral medications in the sulphonylurea class were deemed as having intermediate exocrine pancreas deficit. Those who were able to control their diabetes with oral medications of the biguanide class--with or without the help of diet alteration and those who are diet-controlled without any medications, were considered to be free from exocrine pancreas deficit. Some possible causes of pancreatitis: * Obesity/Overweight: This is true for many dogs diangosed with pancreatitis. It is also more likely to develop when a high-fat diet is being fed. * Hyperlipidemia:or high fat content in the blood. The levels of fat in the blood often rise after eating, but for those without hyperlipidemia, this is a temporary state. Metabolic problems in both pets and people can prevent the removal of fat from the blood. Some studies show that hyperlipidemia can be a cause of pancreatitisHills Pet Care Products-Owner's Guide to Pet Care-Pancreatitis. * Infections--from either viruses (viral) or bacteria (bacterial) can cause pancreatitis in dogs and cats. * Injury: An injury or trauma to the abdominal area can result in injury to the pancreas; this can mean possible pancreatitis. Pancreatitis is often hard to diagnoseFelinediabetes.com-Pancreatitis. Tests include the serum TLI (Trypsin-Like Immunoreactivity)Texas A & M University-Gastrointestinal Laboratory-TLI Test Information, and the feline or canine PLI (Pancreatic Lipase Immunoreactivity)A & M University-Gastrointestinal Laboratory-PLI Test Information, available from the gastrointestinal laboratory at the College of Veterinary Medicine at Texas A&M University. Turnaround from that lab often takes several days. A canine-specific PLI test is also commercially available through IDEXX Laboratories as the Spec cPL™ TestIDEXX Laboratories-Canine Pancreas-Specific Lipase Spec cPL™ Test. Dr. Williams, who is the director of the GI Lab mentioned above, gave this presentation before the World Small Animal Veterinary Association in 2004WSAVA 2004-Pancreatitis in Cats. He notes no specific signs or symptoms which definitely point to pancreatitis in cats. Labwork for dogs has more clear-cut signs of abnormal values than the results can for cats. Some cats have normal lab results and also have pancreatitis Hills Pet Products-Owner's Guide to Pet Care-Pancreatitis. It may be very tricky to treat, also. It can cause insulin resistance, dehydration, and also nausea and vomiting, all of which complicate diabetes. Pets can also begin drinking more water. For the most part, they also commonly show a higher than normal temperature when the disease is in its beginning stages. As pancreatitis progresses, the body temperature may go below normalHills Pet Products-Owner's Guide to Pet Care-Pancreatitis. Some recommended treatments to ask your vet about include: * "resting" the pancreas by withholdingHills Pet Products-Owner's Guide to Pet Care-Pancreatitis all food, water and oral medications for a time frame set by your vet. Subcutaneous fluids bypass the oral route; in avoiding the oral route, the pancreas is also avoided. Medical term for this is "nil per os", or "nothing by mouth". * antioxidants to help reduce the inflammation. * pancreatic enzymes to compensate for pancreatic insufficiencyPeteducation.com (Drs. Foster & Smith)-Pancreatic Insufficiency, but only when indicated by the TLI. * Vitamin B12 injections, especially in the case of existing bowel issues * Subcutaneous fluids to combat dehydration. These can be given at home. Case Studies See Category:Pancreatitis cases for examples of cats and dogs with pancreatitis and their diets and treatments. This FDMB thread link belowFDMB-Pancreatitis Discussion and followups FDMB-Pancreatitis Discussion Followups deal with alternatives and treatments. Further Reading *Lots of good pancreatitis links for cats and dogs *Dr. Stanley Marks' update on Feline Pancreatitis *Sniksnak on Pancreatitis (but W/D food not recommended!) *Pancreatitis and dogs *Pancreatic insufficiency in cats *Introduction to pancreatitis in dogs and cats *Feline Pancreatitis *See also the discussions on FDMB here, here, and here * See Canine Diabetes with rebound hyperglycemia for details about how diabetes with pancreatitis can be difficult, at first. Also details how (rarely!) a canine with pancreatitis and diabetes can begin producing insulin again. * Primer information on pancreatitis * Discussion about the PLI tests from Antech * Discussion about the PLI tests in the Canadian Journal of Veterinary Research *Explaining the Differences in Pancreatitis in Dogs & CatsMore on both-how Chronic Pancreatitis May Affect Cats' Insulin Needs *Can You Rule Out Pancreatitis? Charts, ultrasound photos and a good review of pancreatitis, with a special section for older dogs. *Pancreatitis in Cats--WSAVA 2004 *Feline Pancreatitis--Underdiagnosed & Overlooked-WSAVA 2003 *Pancreatitis in Dogs & Cats-WSAVA 2002 *Pancreatitis in Cats-Diagnosis & Management of a Challenging Disease-JAAHA-2006 *WSAVA 2001-Feline GI Pearls-Pancreatitis *Risk Factors for Pancreatitis in Dogs & Cats-Provet UK References Category:InfectionsCategory:ComplicationsCategory:Other conditions and proceduresCategory:Gastrointestinal Disorders